A  AmoraCare Home Health, Inc. - Terms and Conditions of Service

Effective Date: January 1, 2024

PLEASE READ THESE TERMS AND CONDITIONS CAREFULLY. BY ENGAGING AMORACARE HOME HEALTH, INC. FOR SERVICES, YOU AGREE TO BE BOUND BY THESE TERMS AND CONDITIONS.

Table of Contents

Introduction
Definitions
Acceptance of Terms
Scope of Services
Client and/or Legal Representative Responsibilities
AmoraCare Home Health, Inc. Responsibilities
Care Plan and Modifications
Financial Terms and Billing
Confidentiality and HIPAA Compliance
Safety and Environment
Cancellation, Rescheduling, and Termination of Services
Emergencies
Limitations of Liability
Complaints and Grievances
Governing Law and Jurisdiction
Dispute Resolution
Amendments to Terms
Entire Agreement
Severability
SMS Terms & Conditions
Contact Information
Acknowledgement and Signature
1. Introduction Welcome to AmoraCare Home Health, Inc. We are dedicated to providing compassionate, professional, and high-quality home health care services designed to meet your individualized needs in the comfort and familiarity of your home. This document outlines the mutual responsibilities, expectations, and policies governing the services provided by AmoraCare Home Health, Inc. to its clients. These Terms and Conditions form a legally binding agreement between you, the Client (or your Legal Representative), and AmoraCare Home Health, Inc.

2. Definitions

AmoraCare / Agency / We / Us: Refers to AmoraCare Home Health, Inc.
Client / Patient / You: Refers to the individual receiving home health care services from AmoraCare.
Legal Representative: Refers to the individual legally empowered to make decisions on behalf of the Client (e.g., guardian, power of attorney, authorized family member).
Caregiver / Personnel / Staff: Refers to any employee, contractor, or agent of AmoraCare Home Health, Inc. providing services to the Client. This includes, but is not limited to, skilled nurses, therapists (physical, occupational, speech), home health aides, and medical social workers.
Services: Refers to the home health care services provided by AmoraCare, as detailed in the Client’s individualized Care Plan.
Care Plan: Refers to the individualized plan of care developed by AmoraCare’s clinical staff in consultation with the Client, their physician, and/or Legal Representative, outlining the specific services to be provided.
Protected Health Information (PHI): As defined by the Health Insurance Portability and Accountability Act (HIPAA), refers to any information about the Client's health status, provision of health care, or payment for health care that identifies the Client or could be used to identify the Client.
3. Acceptance of Terms By signing below, or by verbally agreeing to receive services from AmoraCare Home Health, Inc. after receiving a copy of these Terms and Conditions, you acknowledge that you have read, understood, and agree to be bound by these Terms and Conditions. If you are a Legal Representative signing on behalf of a Client, you warrant that you have the full legal authority to do so.

4. Scope of Services a. AmoraCare provides a range of skilled and/or non-skilled home health services as prescribed by a physician and outlined in a personalized Care Plan. These services may include, but are not limited to: * Skilled Nursing Care (e.g., wound care, medication management, injections, disease management education) * Physical Therapy (PT) * Occupational Therapy (OT) * Speech-Language Pathology (SLP) * Home Health Aide (HHA) services (e.g., personal care, assistance with activities of daily living) * Medical Social Work b. All Services are provided in the Client’s residence, or other agreed-upon location, and are subject to the Client's medical needs, physician orders, and the availability of qualified AmoraCare personnel. c. AmoraCare does not provide emergency medical services. In the event of a medical emergency, the Client, Legal Representative, or Caregiver shall immediately contact 911 or emergency services. AmoraCare personnel are trained to assist in contacting emergency services if an emergency arises during a visit. d. The specific duration, frequency, and type of Services will be detailed in the Client’s individualized Care Plan.

5. Client and/or Legal Representative Responsibilities The Client and/or Legal Representative agree to: a. Provide accurate and complete medical history, current health information, contact information, and insurance details to AmoraCare. b. Create and maintain a safe, clean, and respectful environment for AmoraCare personnel to perform their duties without harassment, discrimination, or threat of harm. This includes ensuring safe access to the home. c. Cooperate fully with AmoraCare personnel and adhere to the established Care Plan, including following all instructions and recommendations. d. Promptly inform AmoraCare of any changes in the Client’s medical condition, medications, physician orders, hospitalizations, or living arrangements. e. Notify AmoraCare in advance of any planned absences from the home that would affect scheduled visits. f. Ensure that AmoraCare personnel have access to necessary utilities (e.g., electricity, running water, functional restroom) during visits. g. Not solicit or directly hire any AmoraCare employee or contractor for private services outside of AmoraCare. h. Fulfill all financial obligations as detailed in Section 8. i. Treat AmoraCare personnel with dignity, respect, and courtesy at all times. Any verbal, physical, or emotional abuse, harassment, or discrimination towards AmoraCare personnel will not be tolerated and may lead to immediate termination of services. j. Update emergency contact information as needed.

6. AmoraCare Home Health, Inc. Responsibilities AmoraCare agrees to: a. Provide quality home health care services in accordance with professional standards, physician orders, and the individualized Care Plan. b. Ensure that all Caregivers are qualified, licensed (where applicable), competent, and have undergone appropriate background checks. c. Maintain strict confidentiality of all Client information as mandated by state and federal laws, including HIPAA (see Section 9). d. Develop, implement, and regularly review the Client’s Care Plan in collaboration with the Client, physician, and/or Legal Representative. e. Communicate promptly with the Client, Legal Representative, and physician regarding any significant changes in the Client’s condition or concerns related to care. f. Provide supervision for Caregivers to ensure adherence to the Care Plan and professional standards. g. Have policies and procedures in place to address Client complaints and grievances (see Section 14). h. Treat all Clients with dignity, respect, and professionalism.

7. Care Plan and Modifications a. An individualized Care Plan will be developed by AmoraCare’s clinical staff based on physician orders and a thorough assessment of the Client's needs. b. The Care Plan will be reviewed and updated regularly, or as needed, to reflect changes in the Client's condition, physician orders, or preferences. c. Any modifications to the Care Plan must be approved by the Client, Legal Representative, and/or the prescribing physician, as appropriate.

8. Financial Terms and Billing a. Payment for Services: The Client and/or Legal Representative is ultimately responsible for the timely payment of all charges for Services rendered by AmoraCare. b. Insurance: AmoraCare will bill your insurance provider (e.g., Medicare, Medicaid, private insurance) directly for covered services, provided all necessary authorizations and documentation are in place. However, the Client remains responsible for any co-pays, deductibles, co-insurance, or services not covered by insurance. c. Private Pay: For services not covered by insurance, or for clients opting for private pay, payment terms will be agreed upon in a separate financial agreement. d. Billing Cycle: Invoices will be issued [e.g., weekly, bi-weekly, monthly] and are due upon receipt, or by a specified due date indicated on the invoice. e. Late Fees: A late payment fee of [e.g., 1.5% per month or $25.00] may be applied to balances outstanding for more than [e.g., 30 days] from the invoice date. f. Collections: In the event of non-payment, AmoraCare reserves the right to pursue all available legal remedies to recover outstanding balances, including but not limited to, referring the account to a collection agency or legal counsel. The Client will be responsible for all collection costs, including reasonable attorney's fees. g. Cost of Supplies: The cost of medical supplies, equipment, and medications are generally not included in AmoraCare’s service fees unless specifically stated otherwise in the Care Plan or a separate agreement. The Client is responsible for these costs. h. Financial Hardship: Clients experiencing financial hardship should contact AmoraCare’s billing department immediately to discuss potential payment arrangements.

9. Confidentiality and HIPAA Compliance a. AmoraCare Home Health, Inc. is committed to protecting the privacy and confidentiality of your Protected Health Information (PHI) in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and other applicable federal and state laws. b. Your PHI will be used and disclosed only for treatment, payment, and healthcare operations, or as otherwise permitted or required by law. c. You have the right to receive a copy of AmoraCare’s Notice of Privacy Practices, which provides a detailed explanation of your rights regarding your PHI. d. Our Caregivers will maintain strict confidentiality regarding all aspects of your care and personal information.

10. Safety and Environment a. The Client and/or Legal Representative must ensure a safe and hazard-free environment for AmoraCare personnel. This includes, but is not limited to, maintaining a clean home, securing aggressive pets, and ensuring clear pathways. b. AmoraCare personnel are not authorized to handle firearms or dangerous weapons. Such items should be secured out of reach during visits. c. AmoraCare has a zero-tolerance policy for any form of violence, aggression, harassment, or discrimination towards its personnel. AmoraCare reserves the right to immediately withdraw services if the safety of its personnel is compromised. d. If smoking is permitted in the home, the Client must ensure that AmoraCare personnel are provided a smoke-free working area during their visit.

11. Cancellation, Rescheduling, and Termination of Services a. Client Cancellation/Rescheduling: Clients are required to provide at least [e.g., 24 hours'] advance notice for the cancellation or rescheduling of any scheduled visit. Failure to provide adequate notice may result in a cancellation fee equivalent to the cost of the scheduled visit. b. AmoraCare Cancellation/Rescheduling: AmoraCare reserves the right to cancel or reschedule visits due to unforeseen circumstances, such as Caregiver illness, inclement weather, or emergencies. We will endeavor to provide as much notice as possible and reschedule services promptly. c. Termination by Client: The Client or Legal Representative may terminate Services at any time by providing [e.g., 7 days'] written notice to AmoraCare. All outstanding balances must be paid upon termination. d. Termination by AmoraCare: AmoraCare reserves the right to terminate Services immediately or with reasonable notice if: * The Client fails to meet their responsibilities outlined in Section 5. * Payment for Services is not made as per Section 8. * The Client’s medical needs exceed the scope of services AmoraCare can safely provide in the home setting. * The home environment is deemed unsafe or poses a threat to the well-being of AmoraCare personnel. * There is repeated non-compliance with the Care Plan or physician orders. * There is any instance of abuse, harassment, or discrimination towards AmoraCare personnel. * The Client is admitted to a hospital, skilled nursing facility, or other long-term care facility, making home health services unnecessary. * A mutual agreement between the Client and AmoraCare to terminate services. e. Upon termination of services, AmoraCare will work to ensure a smooth transition of care, including providing referrals to other appropriate services if requested and feasible.

12. Emergencies As stated in Section 4, AmoraCare does not provide emergency medical services. In the event of a medical emergency, AmoraCare personnel will follow established protocols which include, but are not limited to: a. Attempting to contact the Client’s emergency contacts and/or Legal Representative. b. Initiating a call to 911 or local emergency services. c. Providing basic first aid within their scope of practice until emergency medical personnel arrive. AmoraCare is not responsible for the actions or inactions of third-party emergency responders.

13. Limitations of Liability a. While AmoraCare strives to provide the highest quality of care, we do not guarantee specific outcomes or results. Healthcare involves inherent risks, and individual responses to care can vary. b. AmoraCare shall not be liable for any indirect, incidental, special, consequential, or punitive damages, or any loss of profits or revenues, whether incurred directly or indirectly, or any loss of data, use, goodwill, or other intangible losses, resulting from (i) the use or inability to use the Services; (ii) any conduct or content of any third party on the Services; or (iii) unauthorized access, use or alteration of your transmissions or content. c. AmoraCare’s total liability for any claim arising out of these Terms and Conditions or the provision of Services shall not exceed the amount paid by the Client for the Services giving rise to the claim during the [e.g., three (3)] months immediately preceding the event giving rise to the claim. d. AmoraCare is not responsible for any personal belongings or valuables of the Client. Clients are advised to secure their valuables.

14. Complaints and Grievances AmoraCare is committed to resolving Client concerns promptly and effectively. If you have a complaint or grievance regarding the services, personnel, or any aspect of AmoraCare’s operations, please contact Customer Service Support at 972-799-2299 or amoracarehh@amoracarehomehealth.com. All complaints will be investigated thoroughly and addressed in accordance with our internal grievance policy.

15. Governing Law and Jurisdiction These Terms and Conditions shall be governed by and construed in accordance with the laws of the State of [Insert State, e.g., California], without regard to its conflict of law principles. Any legal action or proceeding arising out of or relating to these Terms and Conditions shall be exclusively brought in the state or federal courts located in [Insert County, State, e.g., Los Angeles County, California].

16. Dispute Resolution Any dispute or claim arising out of or relating to these Terms and Conditions or the Services provided shall first be addressed through good faith negotiation between the parties. If the dispute cannot be resolved through negotiation, the parties agree to first attempt resolution through mediation, with a mutually agreed-upon mediator, before resorting to litigation. The costs of mediation shall be shared equally by the parties.

17. Amendments to Terms AmoraCare Home Health, Inc. reserves the right to amend these Terms and Conditions at any time. Any changes will be communicated to the Client and/or Legal Representative in writing, and the updated Terms and Conditions will be deemed effective [e.g., 30 days] after notification, or upon your continued receipt of services, whichever comes first.

18. Entire Agreement These Terms and Conditions, together with the Client’s individualized Care Plan, Notice of Privacy Practices, and any separately executed financial agreements, constitute the entire agreement between the Client and AmoraCare Home Health, Inc. regarding the Services and supersede all prior or contemporaneous understandings and agreements, whether written or oral.

19. Severability If any provision of these Terms and Conditions is found to be unenforceable or invalid by a court of competent jurisdiction, that provision shall be limited or eliminated to the minimum extent necessary so that these Terms and Conditions shall otherwise remain in full force and effect and enforceable.

20. Contact Information For any questions regarding these Terms and Conditions or the Services provided, please contact: AmoraCare Home Health, Inc. 3312 Cassinia PKWY, Heartland, TX 75126 Phone: 972-799-2299 Email: amoracarehh@amoracarehomehealth.com
Website: www.amoracarehomehealth.com

21. SMS Terms & Conditions
A) SMS Consent Communication: The information such as Phone Numbers obtained as part of            the SMS consent process will not be shared with third parties for marketing purposes.
B) Types of SMS Communications: If you have consented to receive text messages from          AmoraCare Home Health, Inc., you may receive messages related to the following:  Appointment
reminders, Follow-up messages, Billing inquiries.
C) Message Frequency: Message frequency may vary depending on the type of communication. 
D) Potential Fees for SMS Messaging: Please note that standard message and data rates may apply, depending on your carrier’s pricing plan. These fees may vary if the message is sent domestically or internationally.
E) Opt-In Method: You may opt-in to receive SMS messages from AmoraCare Home Health, Inc. in the following ways: By submitting an online form or by filling out a paper form.
F) Opt-Out Method: You can opt out of receiving SMS messages at any time. To do so, simply reply "STOP" to any SMS message you receive. Alternatively, you can contact us directly to request removal from our messaging list.
G) Help: If you are experiencing any issues, you can reply with the keyword HELP. Or, you can get help directly from us at Contact US
 Additional Options:
If you do not wish to receive SMS messages, you can choose not to check the SMS consent box on our forms.
H) Standard Messaging Disclosures: Message and data rates may apply. You can opt out at any time by texting "STOP."
For assistance, text "HELP" or visit our Privacy Policy and Terms and Conditions pages.
Message frequency may vary

22. Acknowledgement and Signature

I, the undersigned Client or Legal Representative, acknowledge that I have read, understood, and agree to the Terms and Conditions of Service provided by AmoraCare Home Health, Inc. I understand that these Terms and Conditions are a binding agreement.

Client Name (Printed): _______________________________________

Client Signature: _______________________________________

Date: _______________________________________

Legal Representative Name (Printed): _______________________________________ (If signing on behalf of the Client)

Relationship to Client: _______________________________________

Legal Representative Signature: _______________________________________

Date: _______________________________________

AmoraCare Home Health, Inc. Representative:

Name (Printed): _______________________________________

Title: _______________________________________

Signature: _______________________________________

Date: _______________________________________